Trends in cocaine use over the past 2 decades were compared across levels of education in a population-based US sample of adults. Significant inverse associations between educational achievement and cocaine use after 1990 were driven by dramatic decreases in persistent cocaine use among more highly educated adults, whereas persistent cocaine use remained relatively unchanged among those who did not finish high school. This emerging health disparity highlights the need for improved interventions that target persistent cocaine users with low educational achievement.
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